NASTAD Hepatitis Testing Partnership

Cross-Posted from the U.S. Department of Health & Human Services. Read the original here.

It is estimated that only about half of the people living with hepatitis C virus (HCV) in the United States are aware of their status. This statistic is alarming for a disease that kills more people than the other 60 nationally notifiable conditions combined, and for which incidence rates continue to increase due in part to the opioid crisis and limited availability of critically important prevention programs such as syringe services programs (SSPs). This statistic is even more alarming for a virus that has been deemed the silent killer, because symptoms of more serious liver damage don’t appear until it is often too late. A two-step test that is relatively accessible is often the difference between someone developing serious liver damage or someone being cured.

Despite the advances in treatment options for HCV (the days of interferon are thankfully long gone), we are still seeing low testing numbers and numerous barriers that prevent people from getting tested and diagnosed. Barriers include:

• underfunded hepatitis programs;
• stigma about people who use drugs;
• cost of cure and treatment restrictions based on sobriety, advanced fibrosis scores, or provider type (all of which are not part of the expert treatment guidelines);
• the cost of the RNA confirmatory test;
• limited availability of tests in programs that serve those most at risk of transmission such as corrections and substance use treatment facilities; and
• a lack of awareness that a cure exists for HCV—despite years of awareness raising by advocates.

Despite these barriers, we know that a lot of incredible work is taking place and that if we meaningfully collaborate to leverage ideas, resources, and strategies we can overcome them and achieve greater success. In an effort to help facilitate this process, NASTAD launched the Hepatitis Testing Partnership exit disclaimer icon in 2017 with support from CDC’s Division of Viral Hepatitis. The partnership is a coalition made up of key stakeholders invested in hepatitis testing and linkage to care including health departments, Federally Qualified Health Centers, community based organizations, academic partners, and others currently engaged or who want to be engaged in testing. This group convenes virtually to share best practices, lessons learned, and resources related to testing. Some of the topics we have covered on past webinars include strategies for HCV testing and linkage to care in and from jail and prison; hepatitis prevention, testing, and treatment as liver cancer prevention; and public health detailing as a strategy to increase hepatitis testing. You can find all the recorded webinars and slides archived here.

NASTAD and its partners do this work because we believe testing is a critical entry point to addressing HCV across the continuum. People cannot seek care and be cured without being aware of their status. But we cannot stop at testing. We need to ensure people are being linked to both confirmatory testing and care ─ defining care broadly to include not only HCV treatment, but also primary care, substance use treatment, harm reduction, housing, mental health, and any other unmet needs of our participants. This work cannot be done in isolation ─ it will take a coalition of public health, community partners, people most impacted, departments of corrections, substance use treatment providers, and other key partners at the table. We hope you will join this integral conversation through the Hepatitis Testing Partnership and work to strategize how to increase the number of people who are diagnosed and linked to care for hepatitis, so we can both, improve individual health outcomes, and can move forward together on the path towards hepatitis elimination.

To learn more about and join the partnership or to share examples of effective resources and testing projects that can benefit others working on HCV testing, email akitlas@nastad.org. 

NASTAD is a non-profit association that represents public health officials who administer HIV and hepatitis programs in the U.S. and around the world.